Claims data and encounter data are used for data for administrative, financial and quality control purposes.
Mental Health: Global Level of Functioning (GLOF); Mental Health Statistical Improvement Program (MHSIP) Consumer Survey; Critical Incident Report
Developmental/Intellectual Disability: OPIA, DDL Licensing Inspection System Report; Day/ Employment Audit Activity Report; Qualified Provider Report; Unusual Incident Reporting System (UIRMS); Medicaid Adult Health Quality Measures; CCW/Five Percent Platform; Accrediting Bodies; Unusual Incident Reports
Elderly: Participant File Review Tool; Participant Satisfaction Survey; Level of Care; Plan of Care; Provider Network; Critical Incident Report; Complaints, Grievance and Appeals
Physical Disability: Participant File Review Tool; Participant Satisfaction Survey; Level of Care; Plan of Care; Provider Network; Critical Incident Report; Complaints, Grievance and Appeal; Unusual Incident Reports: Division of Developmental Disabilities, Office of Licensing
How are results made available to LTSS Providers? A copy of the CMS 372 Report will be forwarded on an annual basis; DHS has established an internal MLTSS Quality Strategy work group that has been meeting to develop measures, methods, frequency, data sources and who will be responsible for each quality measure.
MFP; Quality of Life Survey; CAHPS; Participant Experience Survey (PES); National Core Indicators (NCI)
- Participant File Review Tool
- Comprehensive Audits, Targeted Interim Audits, QI Topic Audits
- State Medicaid Annual
- Operating Agency tracking System
- Olmstead Review Process: 30, 60, 90 Survey
NJ is using program funds to expand HCBS for Medicaid recipients through MLTSS under the New Comprehensive Medicaid Waiver (CMW). NJ is also supporting mental health transitions by covering supportive services such as outpatient therapy, counseling and case management.